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Last updated December 3, 2009. Please note that this site represents the latest program changes and differs from the print
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Background: ASCT consolidation in the first
remission is the treatment of choice in MCL patients. However lack of adequate
response to the first line therapy, elderly age and co-existing co-morbidities
makes it feasible for less than a third of patients.

1)At 5 years OS was 40%
in the whole group: 77% for those subjected to post-induction therapy vs 25%
for those who were not; 5 year PFS is 20%, 48% and 5% respectively
(p<0,0001, in both comparisons).

2)Pts with initial good
response, whose treatment was NOT continued after induction, had inferior
results (5 year OS and PFS – 30 and 10 % respectively) to those subjected to
post-induction therapy (p<0,0001).

3)Rituximab included in
the first line regimens increased RR, increasing % of pts that could be subjected
to post-induction therapy: progression/ death during the first line therapy were
5,5% (8/144 Rituximab treated pts) as compared to 15,5% (21/135 treated
without Rituximab).

Conclusions: With all limitations of
retrospective analysis, it strongly supports
the necessity of Rituximab immunochemotherapy followed
by post induction treatment in MCL pts. The
role of ASCT is established in
younger patients, radioimmunotherapy consolidation or
Rituximab maintenance should be considered in elderly and unfit
ones.